The House will begin voting on trade legislation on Thursday, setting up a high-stakes vote Friday on a critical bill to give President Obama fast-track powers.

The complicated new process, laid out by GOP leadership late Wednesday night, is designed to address objections from Minority Leader Nancy Pelosi (D-Calif.) about how the trade package would be structured on the floor.

On Thursday, the House will first take up a trade preferences bill that includes new offsets to pay for Trade Adjustment Assistance (TAA), a related bill that provides aid to workers displaced by trade deals. Those new pay-fors, negotiated by Pelosi and Speaker John Boehner (R-Ohio), would come from increased tax enforcement rather than through cuts to Medicare, which were part of the Senate-passed TAA bill.

Today, Wednesday 10 June 2015, WikiLeaks publishes the Healthcare Annex to the secret draft “Transparency” Chapter of the Trans-Pacific Partnership Agreement (TPP), along with each country’s negotiating position. The Healthcare Annex seeks to regulate state schemes for medicines and medical devices. It forces healthcare authorities to give big pharmaceutical companies more information about national decisions on public access to medicine, and grants corporations greater powers to challenge decisions they perceive as harmful to their interests.

Expert policy analysis, published by WikiLeaks today, shows that the Annex appears to be designed to cripple New Zealand’s strong public healthcare programme and to inhibit the adoption of similar programmes in developing countries. The Annex will also tie the hands of the US Congress in its ability to pursue reforms of the Medicare programme.

The draft is restricted from release for four years after the passage of the TPP into law.

The TPP is the world’s largest economic trade agreement that will, if it comes into force, encompass more than 40 per cent of the world’s GDP. Despite the wide-ranging effects on the global population, the TPP and the two other mega-agreements that make up the “Great Treaty”, (the TiSA and the TTIP), which all together cover two-thirds of global GDP, are currently being negotiated in secrecy. The Obama administration is trying to gain “Fast-Track” approval for all three from the US House of Representatives as early as tomorrow, having already obtained such approval from the Senate.

Julian Assange, WikiLeaks publisher, said:

It is a mistake to think of the TPP as a single treaty. In reality there are three conjoined mega-agreements, the TiSA, the TPP and the TTIP, all of which strategically assemble into a grand unified treaty, partitioning the world into the west versus the rest. This “Great Treaty” is descibed by the Pentagon as the economic core to the US military’s “Asia Pivot”. The architects are aiming no lower than the arc of history. The Great Treaty is taking shape in complete secrecy, because along with its undebated geostrategic ambitions it locks into place an aggressive new form of transnational corporatism for which there is little public support.

Director of Public Citizen’s Global Access to Medicines Program, Peter Maybarduk, and

As the Obama administration praises the benefits of the Trans-Pacific Partnership (TPP), backlash continues to grow against the deal. WikiLeaks has just published another section of the secret text – this one about public healthcare and the pharmaceutical industry. Newly revealed details of the draft show the TPP would give major pharmaceutical companies more power over public access to medicine, and weaken public healthcare programs. The leaked draft also suggests the TPP would prevent Congress from passing reforms to lower drug costs. One of the practices that would be allowed is known as “Evergreening.” It lets drug companies extend the life of a patent by slightly modifying their product and then getting a new patent

The TPP will raise the costs of healthcare globally:

The TPP section requires countries to share decisions about pricing and regulation of drugs with pharmaceutical manufacturers, provide opportunity for comment on those decisions and create a process through which those decisions can be reviewed at the request of affected companies.

According to an analysis of the leaked document by Jane Kelsey (pdf), a law professor at the University of Auckland in New Zealand, these rules are enough to expose national health authorities to legal challenges under TPP’s investor-state dispute settlement process, or ISDS. ISDS empowers companies to challenge countries’ domestic laws before a tribunal of international judges if they believe the laws unfairly limit investment. The tribunals have the power to impose significant fines on countries if their laws are found responsible for the investment hardship in question. While pharmaceutical companies could not challenge national health programs’ policies through ISDS, their grievances would be eligible for ISDS if the companies claimed the policies hindered investment.

The clause removed from a leaked 2011 draft promises pharmaceutical companies the right to charge “competitive market-derived prices,” according to New York Times reporting on the TPP section released by Wikileaks. [..]

Peter Maybarduk, director of Public Citizen’s Global Access to Medicines project, attributed the change to the “unanimous opposition” of non-U.S. TPP negotiating partners, and to U.S. groups like AARP and the labor union American Federation of State, County and Municipal Employees.

Maybarduk and other advocates argue that despite the lack of explicit price requirements in the new draft, the other TPP pharmaceutical and medical device transparency provisions still expose government drug purchasing programs to new legal challenges from pharmaceutical companies.

“The language previously was a little more specifically designed to attack the reimbursement rates” of government drug insurance programs, Maybarduk told The Huffington Post. “Now it is more about process rather than outcomes,” but the intent to undermine government drug price negotiation remains the same.

In an earlier statement (pdf), Maybarduk expressed concern that the rules would “limit Congress’ ability to enact policy reforms that would reduce prescription drug costs for Americans — and might even open to challenge aspects of our health care system today.” companies to challenge countries’ domestic laws before a tribunal of international judges if they believe the laws unfairly limit investment. The tribunals have the power to impose significant fines on countries if their laws are found responsible for the investment hardship in question. While pharmaceutical companies could not challenge national health programs’ policies through ISDS, their grievances would be eligible for ISDS if the companies claimed the policies hindered investment. [..]

But Maybarduk worries that USTR’s assurance notwithstanding, the language of the deal is broad enough to leave open the possibility of challenges to current Medicare policy.

The likelihood that TPP would preclude future Medicare policies is even greater, Maybarduk said. He is concerned that enabling Medicare to negotiate bulk drug prices would not be allowed under TPP. Medicare Part D, the prescription drug program, is currently prohibited from negotiating drug prices, but many health policy experts have touted it as a way to lower costs for Medicare and its beneficiaries.